U.S. Cigarette Warning Labels Are About to Get Graphic

Cigarette packages currently come with a tidy black-bordered warning label, reminding users that smoking causes lung cancer, birth defects and heart disease. Dutiful, yes, and easily disregarded. On Wednesday, the Food and Drug Administration (FDA) unveiled 36 proposed new warning labels designed to grab smokers’ attention. The new labels will cover half of a cigarette pack with graphic warnings — think dead bodies and cancer-ridden lungs — about the risks of smoking. (More on Time.com:Cigarette Warning Labels From Around the World)

The FDA will take public comment about the proposed new labels [PDF] through Jan. 9, 2011, and will choose the final nine by June. Manufacturers will be required to use the graphic warnings labels on all cigarettes sold in the U.S. by Oct. 22, 2012.

The new labels use photos, cartoons and other graphics, along with text captions, to convey health messages about smoking. One label, for instance, reads “Smoking can kill you” and features an image of a corpse with a heart surgery scar. (More on Time.com:Study: Heavy Smoking in Midlife Hikes the Risk of Alzheimer’s)

Health officials hope the proposed new warnings will jump-start the government’s stalled crusade against tobacco. After a long period of decline, smoking rates in the U.S. have plateaued for the last five years at about 20.6% of the adult population; 19.5% of high school students also still smoke. Further, 1,000 children and teenagers become regular smokers every day and 4,000 try smoking for the first time.

“This is the most important change in cigarette health warnings in the history of the United States,” Matthew Myers, president of the Campaign for Tobacco-Free Kids, told the New York Times. (More on Time.com:Declines in U.S. Smoking Rates Remain Stalled)

Many other countries, including Canada, Malaysia, Australia and Brazil [PDF; warning: disturbing images], already have graphic warning labels on cigarettes. And some studies suggest that the more upsetting the better. In a 2008 Brazilian study in the journal Tobacco Control, researchers found that people’s emotional arousal increased in response to negative images of smoking (a depiction of the health effects, for instance) compared with neutral ones (a model holding a cigarette). The idea is that more threatening or arousing images are more likely to trigger avoidance.

In a 2004 Canadian survey of smokers, researchers found that 1 out of 5 participants reported having smoked less due to pictorial health warnings; 1% reported smoking more. Smokers also reported having negative emotional responses to the graphic warnings, such as fear (44%) and disgust (58%), and that those with stronger reactions were more likely to quit or try to quit smoking or reduce tobacco use in the following three months. (More on Time.com: Anxiety Keeps Some Smokers from Quitting)

While discouraging individual smokers from quitting, public-health experts hope the FDA’s proposed new labels will also serve as a broader public-service announcement. A 2009 report by the Tobacco Control Division of the Brazilian Ministry of Health and the National Cancer Institute of Brazil explained why cigarette packs are a key venue for broadcasting public-health messages:

Unlike in the case of other products whose packages are discarded after opening, smokers usually keep the package until they consume all cigarettes. That means that, 24 hours a day, the packages stay with smokers, who take them everywhere, leaving them constantly exposed. For this reason, the packages work as an advertisement, allowing a high degree of social visibility for the product. This is why cigarette packages are referred to as “badge” products, “emblems,” “symbols.”

Packages are also used as a way to create perception about the product.

Color, shape and package lettering perfectly communicate the strength, flavor and expected sensation. Several studies demonstrate how viewing the package affects the way smokers describe the characteristics of the products.

The new labeling measure is among the first rules put forth by the FDA under a 2009 law that gave the agency the authority to regulate tobacco for the first time. My colleague Kate Pickert wrote extensively about the FDA’s new power over tobacco here.